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Biomedical subjects

B Roger

Publications and source records attributed to B Roger.

At least 37 records · Page 2Linked to original sources
PubMed1996

Osteoid osteoma: CT-guided percutaneous excision confirmed with immediate follow-up scintigraphy in 16 outpatients.

PURPOSE: To evaluate treatment of osteoid osteoma with computed tomography (CT)-guided percutaneous excision and immediate follow-up scintigraphy. MATERIALS AND METHODS: Sixteen consecutive adolescent and adult patients underwent CT-guided percutaneous excision of a nidus with 14-gauge biopsy cutting needles, with local anesthesia. After the presence of nidus was confirmed at immediate follow-up scintigraphy, curettage of the bored cavity was performed to remove any residual fragments of the nidus. Scintigraphic and histologic findings were correlated. RESULTS: The nidus was removed successfully in 14 of the 16 patients, with no complications (mean follow-up, 15 months; range, 3-25 months). In five of the 14 patients, immediate follow-up scintigraphy showed incomplete resection of the nidus and immediate second resection was successful. Surgical resection was necessary in two of the 16 patients. CONCLUSION: CT-guided percutaneous excision with immediate follow-up scintigraphy was safe and effective for localization and removal of osteoid osteoma in outpatients.

Adult↗
PubMed1995

[Normal and pathological MRI aspects of the posterolateral corner of the knee].

The purpose of the study is to compare normal PLC anatomy and its MRI appearance, with the various lesions observed in MRI, from the simple popliteus tendinous contusion to the complete PLC rupture. For this specific work on PLC lesions, we selected 61 examinations among the traumatic knees explored during the last 3 years. Surgical correlation is obtained for the 61 patients. MRI examinations are performed on a 0.5 T. unit with gradient echo T1, T1 and T1 GD-DOTA IV. Normal PLC anatomy is compared to the dissection of 4 anatomic subjects. Normal MRI slices are evaluated with this reference analysis. The principle anatomical structures of the PLC include the lateral collateral ligament, the popliteus tendon, the arcuate ligament, the fabello fibular ligament, the posterolateral condylar capsule, and the posterior horn of the lateral meniscus. Surgical findings confirm PLC lesion for 58 patients with 3 false positive. Diagnosis of these lesions is important because chronical posterolateral laxity is secondary to the destabilisation of lateral condyle. Unrecognised and untreated posterolateral instability may result in failure of ACL reconstruction. When clinical tests are doubtful or complex, or the examination very painful, MRI evaluates completely the traumatic knee and particularly the PLC.

Humans↗
PubMed1995

Olfactory learning and memory in the honeybee: comparison of different classical conditioning procedures of the proboscis extension response.

Olfactory learning in the honeybee was investigated using the conditioned proboscis extension reflex on restrained individuals. We compared, under the same experimental conditions, the most commonly used conditioning procedures, i.e. 1 trial, 3 massed trials (1 min inter-trial intervals), and 3 spaced trials (10 min inter-trial intervals) procedures, using linalool as the conditioned stimulus. Two experiments were performed in which worker bees were subjected to: (1) a single test at different times (30 s to 14 days) after the conditioning procedure; (2) a first test within 3 h after the conditioning procedure, and were then retested daily (up to 5 tests). The memory trace of a learnt odorant stimulus could last for the lifetime of the bee, even after a single association with sugar. Repeated tests with 1 day inter-test duration induced a strong decrease of the response level, this effect being more pronounced after a 1-trial conditioning.

Animals↗
PubMed1994

Ultrasono-anatomy of the ankle ligaments.

The ligaments of the ankle are superficial and easily accessible at ultrasonography. Surprisingly, the reliability of this technique has never been proven. With this goal in mind, ten ankles were subjected to a ultrasono-anatomic comparison. The five principle ligamentous fascicles (three on the lateral side and two on the medial side) measured at ultrasonography and the values verified after dissection. This study shows that the ligaments of the ankle are analyzed with ultrasonography and that the measures done are valid and have a precision of 2 mm for the anterior fascicle and the lateral fascicle of the lateral ligamentous plane Due to its simplicity and its low price, ultrasonography appears to be an important method in evaluating the ligaments and the degree of seriousness of ankle sprains.

Ankle Joint↗
PubMed1994

Roentgenographic and magnetic resonance imaging of anterior cruciate reconstruction using a patellar tendon graft--correlations with physical findings.

The purpose of this study was to evaluate the influence of the graft positioning on the clinical outcome and magnetic resonance imaging (MRI) signal of the graft following anterior cruciate ligament (ACL) reconstruction using the central one-third of the patellar tendon. Twenty-two patients with a chronic anterior instability underwent a modified Marshall-MacIntosh procedure, while 27 with a subacute torn ACL had an ACL reconstruction using a free bone-patellar tendon-bone graft. The patients were retrospectively reviewed with a 1.8-year average follow-up (1-3 years). The clinical result was evaluated through the comparative range of motion and the residual laxity as measured with the KT 1,000 arthrometer. The roentgenographic analysis was performed from anteroposterior (AP) and mediolateral (ML) views, made first on one-leg standing with the knee at 30 degrees of flexion, and secondly at "zero" extension with active quadriceps contraction. Lines were drawn to visualise the location of the tibial and femoral tunnels in relation to the tibial plateaus and the intercondylar roof represented by Blumensaat's line. The analysis of the lateral MRI views of the graft allowed discrimination between homogenous and heterogenous graft signals. On lateral roentgenograms of normal knees, it was found that Blumensaat's line crossed the surface of the medial tibial plateau at 30% +/- 9% of its sagittal width (20%-40% range), demonstrating the variability of intercondylar roof inclination. The range of motion was normal in 34 patients (group I), 9 patients had a flexion deficit (group II), and 6 exhibited an extension deficit (group III). The residual laxity was similar in each group (P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Anterior Cruciate Ligament↗
PubMed1994

[Radiologic and MRI evaluation of intra-articular ligamentoplasty using a patellar tendon. Correlations with anatomical results].

INTRODUCTION: the purpose of this study was to evaluate the influence of the graft positioning on the clinical outcome and MRI signal of the graft as well, following ACL reconstruction using the central one-third of the patellar tendon. MATERIAL AND METHODS: twenty one patients having a chronic anterior instability sustained a modified Marshall-Mac Intosh procedure, while 15 having a subacute torn ACL had an ACL reconstruction using a free bone-patellar tendon-bone graft. The patients were retrospectively reviewed with a 1.8 year average follow-up (1-3 years). The clinical result was evaluated through the comparative range of motion, the residual laxity as measured with the KT 1000 arthrometer, and the pivot shift test. The roentgenographic analysis was performed from AP and ML views, made first on one-leg standing with the knee at 30 degrees of flexion, and then in "zero" extension with active quadriceps contraction. Lines were drawn to visualise the location of the tibial and femoral tunnels in relation to the tibial plateaus and the roof of the intercondylar notch represented by the Blumensaat line. The analysis of the AP IRM views of the graft allowed to discriminate between homogeneous and heterogeneous graft signals. RESULTS: on lateral roentgenograms of normal knees it was found that the Blumensaat line crossed the surface of the medial tibial plateau at its anterior third, at 30 +/- 9 per cent (20-40 per cent range), demonstrating the variability of the intercondylar roof inclination. The range of motion was normal in 22 patients (group 1), 8 patients had a flexion deficit (group II), and 6 exhibited an extension deficit (group III). The residual laxity was similar in each group (p > 0.05). When comparing group III to group I, patients from group III had a tibial tunnel significantly more anterior with regard to the Blumensaat line (p < 0.02). In group III, all patients exhibited an heterogeneous MRI graft signal (p < 0.05), and the angle between the intraarticular part of the graft and the tibial tunnel was higher (p < 0.001). These findings were not observed in group II where the location only of the femoral tunnel seemed to influence the flexion deficit (p > 0.05). DISCUSSION AND CONCLUSION: this study demonstrated that the location of the tibial tunnel with regard to the roof of the intercondylar notch, when the knee is in "zero" extension, was the most relevant parameter controlling the extension deficit resulting from a graft impingement. No relation was found between the tibial tunnel location with regard to the tibial plateaus and the mobility deficit. Graft impingement also was always associated with an heterogenous graft MRI signal. CLINICAL RELEVANCE: when reconstructing the ACL care must be taken when inserting the K-wire aimed to guide the tibial drill, to obtain a proper position with regard to the roof of the intercondylar notch. The K-wire location must be checked in "zero" extension. Intra-operative X-rays may help.

Anterior Cruciate Ligament↗
PubMed1993

[Surgical treatment of rupture of the plantar fascia].

Among the various lesions of the hindfoot in athletes, plantar fascia ruptures are not well documented and their surgical treatment is not often reported in the literature. The purpose of the current work was to more precisely define therapeutic indications and to evaluate the results of the surgical treatment based on the excision-release of the plantar fascia. Between 1986 and 1991, 19 patients (5 females, 14 males, average age 32 years) were operated on by one surgeon. All patients were either recreational or competitive athletes. The plantar fascia rupture occurred 18 times during sports activity. Surgical treatment was indicated when pain persisted despite a well conducted conservative treatment. In 17 cases, MRI allowed to plan the operative strategy by showing the fascia lesion. The patients were operated after an average of 8 months following the initial injury (6-16 months). One patient was lost for follow-up, 2 had a follow-up below 6 months, thus 16 patients were available for analysis. The clinical outcome was evaluated through persistence of pain, return to sports, and functional activity. With a 16-month average follow-up (6-51 months) it was observed that pain constantly disappeared and that 11 patients over 16 returned to the same level of sports activity after 6 months with a time-stable result. After failure of a well conducted conservative treatment, surgical treatment of plantar fascia rupture must be proposed. Surgical technique is based not only on fascia release but also on the excision of the pathological scar tissue in order to avoid the restoration of the continuity of the fascia with the calcaneus.

Adult↗
PubMed1991

[Repair by glueing under arthroscopic control of ruptures of the anterior cruciate ligament. Preliminary study of 10 cases controlled by magnetic resonance imaging].

The authors report the results of ten surgical repairs of the anterior cruciate ligament (LCA) by glueing up under arthroscopic control. The functional results were good in 8 cases, with total recovery and full return to sport activities at a level similar to that before the accident. These cases were followed up by magnetic resonance imaging carried out between 2 and 6 months after surgery. This has shown 8 unruptured ligaments but with different signals. No complications were observed and two patients had gone secondary ligamentoplasty due to the failure of the primary repair.

Adolescent↗
PubMed1990

[Cartilaginous and bony anatomy of the human cotyloid cavity: preliminary study for the analysis of the specific dynamics of cotyloid cornua].

Recent studies on acetabular and periacetabular deformations help to understand hip functioning. They encourage a new anatomic analysis of the bony and cartilagenous frameworth of the hip. The authors report as biomechanical preleminary, a radiological and anatomical study on the behavior of the periacetabular region. The results are compared to the anatomical litterature and conclusions are drawn.

Acetabulum↗
PubMed1989

Dynamics of the junction between the medulla and the cervical spinal cord: an in vivo study in the sagittal plane by magnetic resonance imaging.

Sagittal sections of the brain-stem made by MRI reveal differences in the angle formed by the medulla and the cord. In order to study the normal mobility of this region of the CNS during flexion and extension of the head, sagittal MRI studies were made in the sagittal plane in 18 young volunteers. The volunteers were in dorsal decubitus with the cervical spine first flexed and then extended, with the movement localized to the cranio-cervical junction as far as possible. T1-weighted sequences were used, with body coils in 16 cases and surface coils in two. Measurements were related to global cranio-cervical range of movement, movement at the cranio-cervical junction and spino-medullary movement. Variations in the depth of the free space in front of the medulla, pons and spinal cord during movement were also noted. We also checked for downward shift of the lower part of the 4th ventricle and modification of the shape of the ventricle during flexion-extension. The global range of cranio-cervical movement was between 31 and 100 degrees (average 63 degrees). The range between the cranium and C1C2 was 4 to 39 degrees (average 19 degrees) and the spino-medullary range was from 1 to 32 degrees (average 14 degrees). During flexion, the free space narrowed in front of the pons 11 times, in front of the medulla 14 times and in front of the cervical cord 11 times. There was a downward shift of the lower part of the 4th ventricle during flexion in 4 cases but no change in shape was noted. Though this study is open to criticism from several aspects, it may be concluded that variations of the spino-medullary angle in the sagittal plane during flexion-extension do occur, that they are closely correlated with movements at the cranio-cervical junction, moves forward during flexion.

Adult↗
PubMed1989

Pelvic cancers: staging of 139 cases with lymphography and fine-needle aspiration biopsy.

One hundred thirty-nine patients with pelvic cancers (101 bladder carcinomas, 27 prostatic carcinomas, and 11 testicular tumors) considered for radical surgery were studied with lymphography and percutaneous fine-needle aspiration (FNA) biopsy, and the results were correlated with lymphadenectomy. Adequate material for FNA was obtained in 97%, 88%, and 100% of the bladder, prostatic, and testicular tumors, respectively. For bladder carcinoma, the global accuracy was 58% for lymphography and 93% for FNA; the high false-negative rate for lymphography (48%) was lowered to 25% with FNA, providing that the obturator nodes were punctured. For prostatic carcinomas, it was not possible to evaluate the true-positive rate because the patients with positive FNA results did not under-go surgery. For testicular tumors, lymphography and FNA had almost the same global accuracy (73% and 75%), but FNA had a better specificity (100%) than lymphography (86%). FNA had no false-positive results, which means that positive biopsy results obviate radical surgery; when FNA results are negative a lymphadenectomy should be performed. With its mild morbidity, FNA has a role in the preoperative staging of pelvic carcinomas.

Aged↗
PubMed1989

[Results of surgery of nerve trunks in the treatment of post-traumatic brachial plexus paralysis].

Between 1972 and 1985, 256 patients with a brachial plexus injury were operated on in our institution. One hundred fifty-nine post-traumatic injuries, with a minimal follow-up of 2 years for partial palsies and 3 years for complete palsies were reviewed. Clinical examination is particularly important, and CT scan combined with myelography and more recently Magnetic Resonance Imaging ensures exact assessment of the lesions. The operative procedure is described, depending on the level and the number of injured nerve roots. Eighty-six fascicular grafts, 9 trunk grafts and 35 nerve transfers were performed. In 40 cases a neurolysis only was performed. Results were analyzed: at follow-up a motor and sensory recovery was observed in 70% of cases allowing to relieve the pain and to improve the function of the limb. The operation must therefore be performed at the appropriate time according to the most appropriate procedure depending on the number of usable roots. Secondary palliative transfers also help to improve function.

Adolescent↗
PubMed1989

[Magnetic resonance imaging in paralysis of the upper limb of traumatic origin].

We have used magnetic resonance imaging in addition to the other imaging techniques for the examination of 31 patients with traumatic upper limb paralysis. The therapeutic indications of traumatic brachial plexus paralysis depend on the early and precise assessment of the lesions. Computed tomography with a contrast injection at a lumbar level opacifying the subarachnoid spaces provides a morphological study of the canal, spine and nerve roots and of container-contents relationships. In our experience, the diagnostic reliability for the detection of intraspinal radicular lesions is 86%. A study in all 3 spatial planes is possible with MRI with T1- and T2-weighted or gradient echo sequences. The reliability of the technique for the diagnosis of meningoceles in the detection of nerve root avulsion is similar to that of CT (85%). The excellent spatial resolution and natural high contrast allow following the nerve roots in their extraspinal course and determining the site of nerve trunk rupture (50%). The use of oblique and double-obliquity sections should yet improve these results. These first results lead us to proposing magnetic resonance imaging for the exploration of traumatic lesions of the brachial plexus. This nonagressive, more precise and more complete assessment of the lesions certainly has a significant influence on therapeutic choice.

Adolescent↗
PubMed1989

Indianapolis cholesterol screening 1987: does mass screening accomplish its goal?

To evaluate the impact of large scale population screening for elevated total cholesterol, a city-wide event was scheduled in Indianapolis during nine days in February 1987. Altogether, 29,954 individuals were screened, and more than 32% were found to be at moderate or high risk using the classification recommended by the National Institutes of Health at the time of the screening for heart disease on the basis of their total plasma cholesterol concentrations. Although larger numbers of females and whites volunteered to be screened, the screened population represented a broad range of age and education levels. Results of a followup questionnaire returned by 18% of those at moderate of high risk revealed that after receipt of an elevated cholesterol result, 67% of the respondents scheduled a physician visit. The majority of those not doing so (53%) contacted their physician for other reasons or by telephone. Results of the followup indicate that screened subjects responded appropriately to the results received. The results of this project indicate that mass screening is only one tool to successfully identify individuals at risk. Given the biases present in the screened population, other strategies should be used to identify at-risk members of population groups unlikely to participate in similar screening events.

Adult↗
PubMed1988

[Post-traumatic paraosteoarthropathy of the hip. Analysis with x-ray computed tomography and 3-dimensional reconstruction. 2 cases].

Two cases of paraosteoarthropathy developed soon after hip trauma and without associated spinal disorders are described. CT perfectly discriminates ectopic bone formation from osseous fragments and calcified hematoma. These lesions display different signs and have different locations, which allows an easy differentiation. The aetiology of these traumatic osteomas (hip trauma associated with surgical repair in one case coma in the other) is compared to literature. The effectiveness of CT with 3D reconstruction is emphasized in paraosteoarthropathy and hip trauma screening.

Adult↗
PubMed1988

Imaging of posttraumatic brachial plexus injury.

After reviewing a series of 220 patients operated upon between 1975 and 1985 for traumatic brachial plexus injuries, the authors present the results of 103 myelographies, 48 computed tomographies (CT scans) combined with standard myelography, and 25 series of images obtained by magnetic resonance imaging (MRI). To evaluate precisely the type and level of injury, the accuracy of these three techniques was compared with clinical and operative findings. The accuracy of myelography was considered good in 84% of the cases, but 4% were evaluated as false positive results and 12% as false negative or doubtful results. The combined CT scan and myelography reduced the number of doubtful results and accuracy reached 94.25%, but they did not visualize the roots distal to the spinal foramina. MRI correlated well with CT scan images and, in addition, offered visualization of distal radicular injuries. MRI seems a promising diagnostic procedure and should also help to situate nerve grafts and check their viability.

Adult↗